International Journal of Experimental Dental Science

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VOLUME 10 , ISSUE 1 ( January-June, 2021 ) > List of Articles

RESEARCH ARTICLE

Evaluation of Smear Layer after Er:YAG Laser Irradiation in Middle and Apical Third of Mesial Root Canals: A Comparative SEM Investigation

Evrykleia Kourti, Ourania Pantelidou-Papadopoulou, Kosmas Tolidis, Dimitris Strakas

Citation Information : Kourti E, Pantelidou-Papadopoulou O, Tolidis K, Strakas D. Evaluation of Smear Layer after Er:YAG Laser Irradiation in Middle and Apical Third of Mesial Root Canals: A Comparative SEM Investigation. Int J Experiment Dent Sci 2021; 10 (1):14-18.

DOI: 10.5005/jp-journals-10029-1221

License: CC BY-NC 4.0

Published Online: 11-08-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Aim and objective: This ex vivo study evaluated the efficiency of an Er:YAG laser (2940 nm) at different pulse energy levels to remove the smear layer with or without chelators from the middle and apical third of mesial roots. Materials and methods: Thirty-four mesial root canals of first mandibular molars (type II Vertucci) were divided into four groups of eight teeth each. Each group consisted of two subgroups each (A and B), regarding the irrigation protocol. In subgroup A, teeth were rinsed only by distilled water whereas, in subgroup B, teeth were rinsed by 5 mL 17% EDTA for 60 seconds, 5 mL 5% NaOCL, and 5 mL distilled water. The rest two teeth were used as control groups. After coronal access, all teeth were instrumented up to size F3 (30/0.09) and, then, the experimental groups were irradiated by an Er:YAG laser (2940 nm). Four different pulse energy values were tested, namely 30, 50, 70, and 80 mJ to irradiate the roots in group I, group II, group III, and group IV, respectively. The control group (n = 2) was instrumented and rinsed as experimental groups (subgroup B) but not irradiated. Teeth were observed under SEM. Results were statistically analyzed with the Kruskal–Wallis test. Results: There is a statistically significant difference between groups irrigated with chelators and groups with distilled water before laser irradiation in the apical third. Group IB (0.75 W) showed a statistically significant outcome in the apical part. The results showed no statistical difference between subgroup B and the control group. Conclusion: The presence of a chelating factor may play an important role in the laser mechanism of smear layer removal from the apical part of narrow and curved root canals.


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  1. Fried D, Zuerlein M, Featherstone JDB, et al. IR laser ablation of dental enamel: mechanistic dependence on the primary absorber. App Surf Sci 1998;129:852–856. DOI: 10.1016/S0169-4332(97)00755-1.
  2. Zuerlein MJ, Fried D, Featherstone JDB, et al. Optical properties of dental enamel in the mid-IR determined by pulsed photothermal radiometry. Ieee J Select Topics Quantum Electron 1999;5(4):1083–1089. DOI: 10.1109/2944.796333.
  3. Hibst R. Lasers for caries removal and cavity preparation: state of the art and future directions. J Oral Laser Appl 2002;2(4):203–212.
  4. Hibst R, Keller U. Experimental studies of the application of the Er: YAG laser on dental hard substances. I. Measurement of the ablation rate. Lasers Surg Med 1989;9(4):338–344. DOI: 10.1002/lsm.1900090405.
  5. Lukac M, Marincek M, Grad L, et al. Er:YAG pulses for fast and precise cavity preparation. J Oral Laser Appl 2004;4:171–173.
  6. Baraba A, Miletic I, Jukic Krmek A, et al. Ablative potential of the erbium-doped yttrium aluminium garnet laser and conventional handpieces: a comparative study. Photomed Laser Surg 2009;27(6):921–927. DOI: 10.1089/pho.2008.2416.
  7. Takeda FH, Harashima T, Kimura Y, et al. Comparative study about the removal of smear layer by three types of laser devices. J Clin Laser Med Surg 1998;16(2):117–122. DOI: 10.1089/clm.1998.16.117.
  8. Takeda FH, Harashima T, Kimura Y, et al. Efficacy of Er: YAG laser irradiation in removing debris and smear layer on root canal walls. J Endod 1998;24(8):548–551. DOI: 10.1016/S0099-2399(98)80075-7.
  9. Takeda FH, Harashima T, Kimura Y, et al. A comparative study of the removal of smear layer by three endodontic irrigants and two types of laser. Int Endod J 1999;32(1):32–39. DOI: 10.1046/j.1365-2591.1999.00182.x.
  10. Pecora JD, Brugnera-Junior A, Cussioli AL, et al. Evaluation of dentin root canal permeability after instrumentation and Er: YAG laser application. Laser Surg Med 2000;26(3):277–281. DOI: 10.1002/(sici)1096-9101(2000)26:33.0.co;2-m.
  11. Fried D. IR laser ablation of dental enamel. In: Featherstone JDB, Rechmann P, Fried D, ed. Lasers in Dentistry VI. Volume Proc. SPIE, vol. 3910 2000. pp. 136–148.
  12. Seka W, Featherstone JDB, Fried D, et al. Laser ablation of dental hard tissues from explosive ablation to plasma mediate ablation. In: Wigdor HA, Featherstone JD, White JM, et al., ed. Lasers in Dentistry II. Proc SPIE, vol. 2672 1996. pp. 144–158.
  13. Vertucci F, Seelig A, Gillis R. Root canal morphology of the human maxillary second premolar. Oral Surg Oral Med Oral Pathol 1974;58(3):456–464. DOI: 10.1016/0030-4220(74)90374-0.
  14. Al-Nazhan S. Incidence of four canals in root-canal-treated mandibular first molars in a Saudi Arabian sub-population. Int Endod J 1999;32(1):49–52. DOI: 10.1046/j.1365-2591.1999.00188.x.
  15. Al-Qudah AA, Awawdeh LA. Root and canal morphology of mandibular first and second molar teeth in a Jordanian population. Int Endod J 2009;42(9):775–784. DOI: 10.1111/j.1365-2591.2009.01578.x.
  16. Wang Y, Zheng Q-H, Zhou X-D, et al. Evaluation of the root and canal morphology of mandibular first permanent molars in a western Chinese population by cone beam computed tomography. J Endod 2010;36(11):1786–1789. DOI: 10.1016/j.joen.2010.08.016.
  17. de Pablo OV, Estevez R, Peix Sanchez M, et al. Root anatomy and canal configuration of the permanent mandibular first molar: a systematic review. J Endod 2010;36(12):1919–1931. DOI: 10.1016/j.joen.2010.08.055.
  18. Mader CL, Baumgartner JC, Peters DD. Scanning electron microscopic investigation of the smeared layer on root canal walls. J Endod 1984;10(10):477–483. DOI: 10.1016/S0099-2399(84)80204-6.
  19. Diaci J, Gaspirc B. Review comparison of Er: YAG and Er, Cr: YSGG lasers used in dentistry. J Laser Health Acad 2012. 1.
  20. Armengol V, Jean A, Rohanizadeh R, et al. Scanning electron microscopic analysis of diseased and healthy dental hard tissues after Er:YAG laser irradiation: in vitro study. J Endod 1999;25(8):543–546. DOI: 10.1016/S0099-2399(99)80376-8.
  21. Brugnera AJR, Zanin F, Barbin EL, et al. Effects of Er: YAG and Nd: YAG laser irradiation on radicular dentine permeability using different irrigating solutions. Lasers Surg Med 2003;33(4):256–259. DOI: 10.1002/lsm.10214.
  22. Kivanc BH, Arisu HD, Ozcan S, et al. The effect of the application of gaseous ozone and Nd: YAG laser on glass-fibre post bond strength. Aust Endod J 2012;38(3):118–123. DOI: 10.1111/j.1747-4477.2010.00265.x.
  23. Di Vito E, Colonna MP, Olivi G. The photoacoustic efficacy of an Er:YAG laser with radial and stripped tips on root canal dentin walls: an SEM evaluation. J Laser Dentis 2011;19(1):156–161.
  24. DiVito E, Lloyd A. Er: YAG laser for 3-dimensional debridement of canal systems: use of photon-induced photoacoustic streaming. Dent Today 2012;31(122):124–127.
  25. Prabhu NT, Munshi AK. Additional distal root in permanent mandibular first molars: report of a case. Quintess Int 1995;26(8):567–569.
  26. Schumann C. Endodontic treatment of a mandibular first molar with radix entomolaris: a case report. Endo (Lond Engl) 2008;2:301–304.
  27. Herrmann H-W. Using the AdvErL Evo laser for endodontic treatments. Laser 2017;3:20–23.
  28. Henninger E, Berto LA, Eick S, et al. In vitro wffect of Er:YAG laser on different single and mixed microorganisms being associated with endodontic infections. Photobiomodulat, Photomed, Laser Surg 2019;37(6):369–375. DOI: 10.1089/photob.2018.4557.
  29. Ramalho KM, Marques MM, Apel C, et al. Morphological analysis of root canal walls after Er:YAG and Nd:YAG laser irradiation: a preliminary SEM investigation. JOLA 2005;5(2):91–96.
  30. Perez F, Calas P, Rochd T. Effect of dentin treatment on in vitro root tubule bacterial invasion. Oral Surg Oral Med Oral Pathol 1996;82(4):446–451. DOI: 10.1016/s1079-2104(96)80313-1.
  31. Ciucchi B, Khettabi M, Holz J. The effectiveness of different endodontic irrigation procedures on the removal of the smear layer: a scanning electron microscopic study. Int Endod J 1989;22(1):21–28. DOI: 10.1111/j.1365-2591.1989.tb00501.x.
  32. Dhawan S, Jasuja P, Khurana H, et al. A comparative evaluation of the efficacy of erbium: yttrium–aluminum–garnet and diode lasers in smear layer removal and dentin permeability of root canal after biomechanical preparation – a scanning electron microscopy study. J Indian Soc Pedod Prev Dent 2020;38(1):64–70. DOI: 10.4103/JISPPD.JISPPD_174_19.
  33. Meister J, Apel C, Franzen R, et al. Influence of the spatial beam profile on hard tissue part I: multimode emitting Er:YAG lasers. Lasers Med Sci 2003;18(2):112–118. DOI: 10.1007/s10103-003-0263-9.
  34. Meister J, Franzen R, Apel C, et al. Multireflection pumping concept for miniaturized ablation diode-pumped solid-state lasers. Appl Opt 2004;43(31):5864–5869. DOI: 10.1364/ao.43.005864.
  35. Apel C, Franzen R, Meister J, et al. Influence of the pulse duration of an Er:YAG laser system on the ablation threshold of dental enamel. Lasers Med Sci 2002;17(4):253–257. DOI: 10.1007/s101030200037.
  36. Meister J, Franzen R, Forner K, et al. Influence of the water content in dental enamel and dentin on ablation with erbium YAG and erbium YSGG lasers. J Biomed Opt 2006;11(3):34030. DOI: 10.1117/1. 2204028.
  37. Torabinejad M, Khademi AA, Babagoli J, et al. A new solution for the removal of the smear layer. J Endod 2003;29(3):170–175. DOI: 10.1097/00004770-200303000-00002.
  38. Gutnecht N. Lasers in endodontics. J Laser Health Acad 2008. 4.
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